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Focal slowing of nerve conduction velocity in leprosy patients unveiled through multisegmented nerve analysis.
Daccach, Vanessa; Tomaselli, Pedro José; Algemiro, Juliana Secchin; Toscano, Patricia; Dos Santos, André Cleriston José; Frade, Marco Andrey Cipriano; Marques, Wilson.
Afiliación
  • Daccach V; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Tomaselli PJ; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Algemiro JS; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Toscano P; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Dos Santos ACJ; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Frade MAC; Dermatology, Clinical Medicine Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
  • Marques W; Neuroscience and Behavior Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
J Peripher Nerv Syst ; 29(3): 356-362, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39165030
ABSTRACT
BACKGROUND AND

AIMS:

Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae), an intracellular bacillus that systematically invades the peripheral nerves. Diagnosing leprosy neuropathy is still a defying skill, and late diagnosis and treatment are still a reality. Based on the biological characteristics of M. leprae, particularly its preference for invading the Schwann cells localized at the coldest areas of human body, we hypothesized that these areas have focal demyelination that may escape detection through standard nerve conduction studies (NCSs) protocols.

METHODS:

Twenty-five patients with confirmed multibacillary leprosy and 14 controls were accessed. A multisegmented NCS protocol (MP) was performed, targeting short segments through the coldest areas, to identify focal areas of slowed conduction velocity. The effectiveness of this multisegmented protocol was compared to the standard protocol (SP) to detect abnormalities.

RESULTS:

All leprosy patients presented an abnormal study with the MP, contrasting to 19 with the SP. The most frequent NCS pattern was an asymmetric neuropathy with focal slowing of conduction velocity, found in 23 out of 25 leprosy patients. Significant differences favoring the proposed method were observed when comparing the MP with the SP. Notably, the MP increased the sensitivity to detect abnormalities by 122%, 133%, and 257% for the median, peroneal, and tibial nerves, respectively. MP also increases sensitivity to detect focal abnormalities in the ulnar nerve.

INTERPRETATION:

The MP protocol significantly increases the sensitivity of NCSs to detect neurophysiological abnormalities in leprosy neuropathy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conducción Nerviosa Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Peripher Nerv Syst Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conducción Nerviosa Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Peripher Nerv Syst Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos